沈巍 叶一 柴澄 谢凯

[摘要] 目的 探討不同矫形器对脊髓损伤患者临床康复效果的影响。 方法 选取2016年9月～2019年3月我院收治的脊髓损伤患者124例为研究对象。按照随机数字表法分为A组和B组，每组62例。A组患者装配重心移动式步行矫形器，B组患者装配往复式截瘫步行器。比较两组患者矫形器装配前后的行走能力、日常生活能力、生活自理能力以及肠道功能的改善情况。 结果 矫形器装配前和装配后6周时，A组与B组患者的行走能力、Barthel和FIM评分以及肠道功能比较，差异无统计学意义（P>0.05）;与矫形器装配前比较，两组患者装配后6周时的行走能力、Barthel评分和FIM评分以及肠道功能均显著改善，差异有统计学意义（P<0.05）。 结论 两种矫形器均能改善脊髓损伤患者的行走能力、日常生活能力、生活自理能力以及肠道功能，有利于患者的康复;但由于本次研究的样本量较少，仍需进一步的研究来阐明矫形器促进脊髓损伤患者康复的机制。

[关键词] 脊髓损伤;矫形器;行走能力;肠道功能;临床康复

[中图分类号] R651.2          [文献标识码] B          [文章编号] 1673-9701（2020）17-0084-03

Effect of different orthoses on clinical rehabilitation of patients with spinal cord injury

SHEN Wei   YE Yi   CHAI Cheng   XIE Kai

Department of Rehabilitation，Affiliated Hospital of Ningbo University Medical College，Ningbo   315020，China

[Abstract] Objective To investigate the effect of different orthoses on the clinical rehabilitation of patients with spinal cord injury. Methods A total of 124 patients with spinal cord injury admitted to our hospital from September 2016 to March 2019 were enrolled. According to the random number table method， they were divided into group A and group B，with 62 cases in each group. Patients in the group A were equipped with a center-of-gravity mobile walking orthosis，and patients in the group B were equipped with a reciprocating paraplegic walker. The walking ability，daily living ability，self-care ability and improvement of intestinal function before and after orthodontic assembly were compared between the two groups. Results Before and at 6 months after the orthosis assembly， there were no significantly differences in the walking ability， Barthel and FIM scores and intestinal function of patients between group A and group B（P>0.05）. Compared with those before orthoplasty， the walking ability， Barthel score， FIM score and intestinal function of the two groups were significantly improved at 6 weeks after assembly， and the difference was statistically significant（P<0.05）. Conclusion Both orthoses can improve the walking ability，daily living ability，self-care ability and intestinal function of patients with spinal cord injury，which is conducive to the rehabilitation of patients. However，due to the small sample size of this study，further research is needed to elucidate the mechanism by which orthoses promote the rehabilitation of patients with spinal cord injury.

[Key words] Spinal cord injury;Orthosis;Walking ability;Intestinal function;Clinical rehabilitation

脊髓损伤（Spinal cord injury，SCI）是指由于各种原因导致的脊髓结构和功能损伤，进而导致损伤平面以下的运动神经、感觉神经等不同程度的功能障碍，致残、致死率较高[1]，全球每年脊髓损伤的患者高达200万[2]，严重影响了人们的日常生活。随着医疗水平不断进步，临床上对SCI的治疗与过去比较有了较大的发展，但目前仍无法使脊髓损伤患者的脊髓功能完全恢复[3]，高位脊髓损伤患者仍需以轮椅代步，进而导致褥疮、心肺功能障碍、代谢紊乱、膀胱感染等并发症。矫形器的出现为脊髓损伤患者的临床康复带来可能。基于以上原因，本文探讨不同的矫形器对脊髓损伤患者临床康复效果的影响，为不同矫形器的临床应用提供参考，现报道如下。